Peptide receptor radionuclide therapy for patients with somatostatin receptor expressing tumours. German Guideline (S1).

This document describes the guideline for peptide receptor radionuclide therapy (PRRT) published by the German Society of Nuclear Medicine (DGN) and accepted by the Association of the Scientific Medical Societies in Germany (AWMF) to be included in the official AWMF Guideline Registry. These recommendations are a prerequisite for the quality management in the treatment of patients with somatostatin receptor expressing tumours using PRRT. They are aimed at guiding nuclear medicine specialists in selecting likely candidates to receive PRRT and to deliver the treatment in a safe and effective manner. The recommendations are based on an interdisciplinary consensus. The document contains background information and definitions and covers the rationale, indications and contraindications for PRRT. Essential topics are the requirements for institutions performing the therapy, e. g. presence of an expert for medical physics, intense cooperation with all colleagues involved in the treatment of a patient, and a certificate of instruction in radiochemical labelling and quality control are required. Furthermore, it is specified which patient data have to be available prior to performance of therapy and how treatment has to be carried out technically. Here, quality control and documentation of labelling are of great importance. After treatment, clinical quality control is mandatory (work-up of therapy data and follow-up of patients). Essential elements of follow-up are specified in detail. The complete treatment inclusive after-care has to be realised in close cooperation with the involved medical disciplines. Generally, the decision for PRRT should be undertaken within the framework of a multi-disciplinary tumour board.

From Matterhorn to Mt Everest: empowering rescuers and improving medical care in Nepal.

This article describes a private initiative in which professional Swiss rescuers, based at the foot of the Matterhorn, trained Nepalese colleagues in advanced high altitude helicopter rescue and medical care techniques. What started as a limited program focused on mountain safety has rapidly developed into a comprehensive project to improve rescue and medical care in the Mt Everest area for both foreign travelers and the local Nepalese people.

Job satisfaction of Swiss general practitioners with and without proficiency certificate in homeopathy

Introduction: Job satisfaction and therefore wellbeing of physicians is an important issue in high quality and safety of health care provision. The role of additional qualification in complementary medicine (CM) for job satisfaction of general practitioners (GPs), however, has not been explored. This study compared job satisfaction of conventional and homeopathic Swiss GPs. Methods: Participants of the Swiss Family Doctors Conference 2013 and members of the Swiss Association of Homeopathic Physicians participated in the survey. They indicated the extent of job satisfaction on 17 questions covering patient care, work-related burden, income-prestige, personal rewards, and professional relations. Results: Data of n = 125 GPs with homeopathic proficiency certificate and data of n = 143 GPs without any proficiency certificate in CM were analyzed. Overall job satisfaction was high and did not differ between the groups. However, due to lower number of patients per day, homeopathic GPs reported higher satisfaction in relations with patients and with workload, and lower satisfaction with income and in relations with peers compared to conventional GPs. Controlling for further confounding variables (e.g. working hours per week, practice setting), homeopathic GPs reported less satisfaction with their income than their conventional colleagues. Conclusions: Longer consultation time and lower number of patients homeopathic GPs see per day, may allowthem to unfold a deeper and more satisfying relationship with their patients and to lessen the workload. However, this comes along with financial discontent compared to conventional GPs. Certification in homeopathy and increased consultation time, respectively, may represent a way to enhance GPs’ job satisfaction.

Gallipoli: Myths and Memories in a transnational perspective

The battle of Gallipoli as it is known in Europe and South Asia or the battle of Çannakkale as it is known in modern Turkey was a seminal battle for many nations, not because it was decisive for the course of the war, but because it played a central role in regard to memory of the First World War in many nations. Based on photographic evidence and research by colleagues from many countries this contribution will focus in a transnational perspective on the participation of British, Indian, Australian and New Zealand troops in the campaign and especially on myths and memories on the side of the Entente from 1916 onwards.

Arterial blood pressure targets in septic shock: is it time to move to an individualized approach?

Xu and colleagues evaluated the impact of increasing mean arterial blood pressure levels through norepinephrine administration on systemic hemodynamics, tissue perfusion, and sublingual microcirculation of septic shock patients with chronic hypertension. The authors concluded that, although increasing arterial blood pressure improved sublingual microcirculation parameters, no concomitant improvement in systemic tissue perfusion indicators was found. Here, we discuss why resuscitation targets may need to be individualized, taking into account the patient's baseline condition, and present directions for future research in this field.

Sexual harassment over the telephone: Occupational risk at call centers

The phenomenon of sexually harassing telephone calls in the workplace has been studied only marginally. In the present study 106 employees working in call centres in Germany answered a questionnaire regarding their experiences of sexual harassment over the telephone. The following data are presented: description of the phenomenon, i.e. prevalence and characteristics, stress reactions of the victims, behavioural reactions and coping strategies, consequences and anticipated consequences; prediction of the stress reactions by characteristics of the situation; and employees' recommendations for coping with sexually harassing calls. It was found that the female employees were more often sexually harassed over the telephone at work than their male colleagues. Three out of four female employees had experienced sexually harassing telephone calls; in the majority of cases the harassers were men. Characteristic patterns of harassment included groaning, sexual insults, silence, and threats of sexual violence. Some 16% of the harassed female employees described these experiences as extremely stressful. If the harassment contained threats of sexual violence and groaning, the perceived physical response was stronger. Being subjected to sexual harassment over the telephone both at home and at work was a more severe stress than having the experience only in the workplace. In conclusion, employees' recommendations for coping with the occurrence of sexually harassing calls are described.

Luxembourgish farmers lack information about grain legume cultivation

Grain legume production in Europe has decreased in recent years, while legume demand has rapidly increased due to growth of meat production. Therefore, Europe imports grain legumes, principally soybeans, to meet feed protein requirements. Various investigations have identified problems and benefits of local grain legume cultivation. Nevertheless, grain legume cultivation has still not increased in the last years. Studies investigating why farmers do not cultivate grain legumes are missing. Here, we surveyed the knowledge of farmers about grain legume cultivation, problems and constraints of grain legume cultivation and the barriers faced by and incentives needed by farmers. We sent a questionnaire to 1373 farmers in Luxembourg, with a response rate of 29 %. Results show that only 17 % of all the responding farmers cultivated grain legumes; 88 % of the conventional farmers did not cultivate grain legumes, while 85 % of the organic farmers did. We observed that Luxembourgish farmers feel badly informed about grain legume cultivation; organic farmers generally feel better informed than their conventional colleagues. The main barrier, named by Luxemburgish farmers to not cultivate grain legumes, is not economic issues but a lack of knowledge and extension services for these crops. Main incentives needed to start grain legume cultivation in the future are economic issues. Even though grain legume producers mentioned several negative experiences with grain legume cultivation, they are not discouraged by the poor economic conditions and appreciate the benefits of grain legume cultivation. Overall, our findings show that research results on grain legume should be better disseminated to extension services and farmers.

The Character of Christian-Muslim Encounter: Essays in Honour of David Thomas

The Character of Christian-Muslim Encounter is a Festschrift in honour of David Thomas, Professor of Christianity and Islam, and Nadir Dinshaw Professor of Inter Religious Relations, at the University of Birmingham, UK. The Editors have put together a collection of over 30 contributions from colleagues of Professor Thomas that commences with a biographical sketch and representative tribute provided by a former doctoral student, and comprises a series of wide-ranging academic papers arranged to broadly reflect three dimensions of David Thomas’ academic and professional work – studies in and of Islam; Christian-Muslim relations; the Church and interreligious engagement. These are set in the context of a focussed theme – the character of Christian-Muslim encounters – and cast within a broad chronological framework.

Lipid topogenesis - 35years on

Glycerophospholipids are the principal fabric of cellular membranes. The pathways by which these lipids are synthesized were elucidated mainly through the work of Kennedy and colleagues in the late 1950s and early 1960s. Subsequently, attention turned to cell biological aspects of lipids: Where in the cell are lipids synthesized? How are lipids integrated into membranes to form a bilayer? How are they sorted and transported from their site of synthesis to other cellular destinations? These topics, collectively termed 'lipid topogenesis', were the subject of a review article in 1981 by Bell, Ballas and Coleman. We now assess what has been learned about early events of lipid topogenesis, i.e. "lipid synthesis, the integration of lipids into membranes, and lipid translocation across membranes", in the 35years since the publication of this important review. We highlight the recent elucidation of the X-ray structures of key membrane enzymes of glycerophospholipid synthesis, progress on identifying lipid scramblase proteins needed to equilibrate lipids across membranes, and new complexities in the subcellular location and membrane topology of phosphatidylinositol synthesis revealed through a comparison of two unicellular model eukaryotes.

Developing an alternative response format for the script concordance test

Introduction: Clinical reasoning is essential for the practice of medicine. In theory of development of medical expertise it is stated, that clinical reasoning starts from analytical processes namely the storage of isolated facts and the logical application of the ‘rules’ of diagnosis. Then the learners successively develop so called semantic networks and illness-scripts which finally are used in an intuitive non-analytic fashion [1], [2]. The script concordance test (SCT) is an example for assessing clinical reasoning [3]. However the aggregate scoring [3] of the SCT is recognized as problematic [4]. The SCT`s scoring leads to logical inconsistencies and is likely to reflect construct-irrelevant differences in examinees’ response styles [4]. Also the expert panel judgments might lead to an unintended error of measurement [4]. In this PhD project the following research questions will be addressed: 1. How does a format look like to assess clinical reasoning (similar to the SCT but) with multiple true-false questions or other formats with unambiguous correct answers, and by this address the above mentioned pitfalls in traditional scoring of the SCT? 2. How well does this format fulfill the Ottawa criteria for good assessment, with special regards to educational and catalytic effects [5]? Methods: 1. In a first study it shall be assessed whether designing a new format using multiple true-false items to assess clinical reasoning similar to the SCT-format is arguable in a theoretically and practically sound fashion. For this study focus groups or interviews with assessment experts and students will be undertaken. 2. In an study using focus groups and psychometric data Norcini`s and colleagues Criteria for Good Assessment [5] shall be determined for the new format in a real assessment. Furthermore the scoring method for this new format shall be optimized using real and simulated data.

Young medical educators' workshop: Finding the right mentor in Medical Education

Background: Finding the right mentor in medical education is challenging, especially if you are relatively new to the field. However, a mentor that is fit for purpose offers great potential. The workshop will explore strategies and pitfalls for successfully finding the best available mentor. Intended Outcomes: At the end of the workshop participants will be able to: (1) identify practical strategies for successfully finding the right mentor in medical education; (2) give feedback on a proposed idea of a platform for matching mentees and mentors within AMEE; (3) establish an electronic network for continued dialogue and support within the online platform of AMEE (MedEdWorld). Structure: After an introduction to mentorship in medical education and characteristics of effective mentors, participants will have the opportunity to develop their own concepts and questions and discuss them with other participants and facilitators. Senior mentors will give advice from their experience. Furthermore, a proposal of an online platform to help young medical educators find a mentor will be presented and discussed. Who Should Attend: Young medical educators interested in finding the right mentor and in exchanging ideas with colleagues in a similar situation. Level: Introductory

A new Stata command for computing and graphing percentile shares

Percentile shares provide an intuitive and easy-to-understand way for analyzing income or wealth distributions. A celebrated example are the top income shares sported by the works of Thomas Piketty and colleagues. Moreover, series of percentile shares, defined as differences between Lorenz ordinates, can be used to visualize whole distributions or changes in distributions. In this talk, I present a new command called pshare that computes and graphs percentile shares (or changes in percentile shares) from individual level data. The command also provides confidence intervals and supports survey estimation.

A new Stata command for computing and graphing percentile shares

Percentile shares provide an intuitive and easy-to-understand way for analyzing income or wealth distributions. A celebrated example is the top income shares sported by the works of Thomas Piketty and colleagues. Moreover, series of percentile shares, defined as differences between Lorenz ordinates, can be used to visualize whole distributions or changes in distributions. In this talk, I present a new command called pshare that computes and graphs percentile shares (or changes in percentile shares) from individual level data. The command also provides confidence intervals and supports survey estimation.

Taking Transgenic Plants with a Pinch of Salt

Making plants resistant to salty environments would be a boon for developing countries where poor land management has rendered large areas of arable land unfit for crop production. In a Perspective, Frommer and colleagues discuss how genetic engineering can be used to confer salt tolerance on plants ( see Apse et al.) and explore the implications of this feat for improving crop production in developing countries.

Cooperation & Competition Between Navigation Systems in the Rat Brain: The Role of the Hippocampus and Striatum During a Dissociative Maze Task

While many tend to think of memory systems in the brain as a single process, in reality several experiments have supported multiple dissociations of different forms of learning, such as spatial learning and response learning. In both humans and rats, the hippocampus has long been shown to be specialized in the storage of spatial and contextual memory whereas the striatum is associated with motor responses and habitual behaviors. Previous studies have examined how damage to hippocampus or striatum has affected the acquisition of either a spatial or response navigation task. However even in a very familiar environment organisms must continuously switch between place and response strategies depending upon circumstances. The current research investigates how these two brain systems interact under normal conditions to produce navigational behavior. Rats were tested using a task developed by Jacobson and colleagues (2006) in which the two types of navigation could be controlled and studied simultaneously. Rats were trained to solve a plus maze using both a spatial and a response strategy. A cue (flashing light) was employed to indicate the correct strategy on a given trial. When no light was present, the animals were rewarded for making a 90º right turn (motor response). When the light was on, the animals were rewarded for going to a specific goal location (place strategy). After learning the task, animals had a sham surgery or dorsal striatum or hippocampus damaged. In order to investigate the individual role of each brain system and evaluate whether these brain regions compete or cooperate for control over strategy, we utilized a within-animal comparisons. The configuration of the maze allowed for the comparison of behavior in individual animals before and after specific brain areas were damaged. Animals with hippocampal lesions showed selective deficits on place trials after surgery and learned the reversal of the motor response more rapidly than striatal lesioned or sham rats. Unlike previous findings regarding maze learning, animals with striatal lesions showed deficits in both place and response trials and had difficulty learning the reversal of motor response. Therefore, the effects of lesions on the ability to switch back and forth between strategies were more complex than previously suggested. This work may reveal important new insight on the integration of hippocampal and striatal learning systems, and facilitate a better understanding of the brain dynamics underlying similar navigational processes in humans.